Identifying indicators sensitive to primary healthcare nurse practitioner practice: A review of systematic reviews

• Published in: PloS one 2023-09, Vol.18 (9), p.e0290977-e0290977
• Main Authors: Kilpatrick, Kelley, Tchouaket, Eric, Savard, Isabelle, Chouinard, Maud-Christine, Bouabdillah, Naima, Provost-Bazinet, Bruno, Costanzo, Gina, Houle, Julie, St-Louis, Geneviève, Jabbour, Mira, Atallah, Renée
• Format: Article
• Language: English
• Subjects: Activities of daily living; Advanced practice nurses; Best practice; Bias; Care and treatment; Categories; Education; Emergency medical care; Emergency medical services; Health care; Health care industry; Health services; Indicators; Indigenous peoples; Literature reviews; Long term health care; Medical care; Medicine and Health Sciences; Mortality; Multiculturalism; Nurse practitioners; Nurses; Patient compliance; Patient education; Patients; People and Places; Physical Sciences; Physicians; Practice; Primary care; Quality management; Quality of life; Research and Analysis Methods; Safety; Signs and symptoms; Trends
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0290977

Aim To identify indicators sensitive to the practice of primary healthcare nurse practitioners (PHCNPs). Materials and methods A review of systematic reviews was undertaken to identify indicators sensitive to PHCNP practice. Published and grey literature was searched from January 1, 2010 to December 2, 2022. Titles/abstracts (n = 4251) and full texts (n = 365) were screened independently by two reviewers, with a third acting as a tie-breaker. Reference lists of relevant publications were reviewed. Risk of bias was examined independently by two reviewers using AMSTAR-2. Data were extracted by one reviewer and verified by a second reviewer to describe study characteristics, indicators, and results. Indicators were recoded into categories. Findings were summarized using narrative synthesis. Results Forty-four systematic reviews were retained including 271 indicators that were recoded into 26 indicator categories at the patient, provider and health system levels. Nineteen reviews were assessed to be at low risk of bias. Patient indicator categories included activities of daily living, adaptation to health conditions, clinical conditions, diagnosis, education-patient, mortality, patient adherence, quality of life, satisfaction, and signs and symptoms. Provider indicator categories included adherence to best practice-providers, education-providers, illness prevention, interprofessional team functioning, and prescribing. Health system indicator categories included access to care, consultations, costs, emergency room visits, healthcare service delivery, hospitalizations, length of stay, patient safety, quality of care, scope of practice, and wait times. Discussion Equal to improved care for almost all indicators was found consistently for the PHCNP group. Very few indicators favoured the control group. No indicator was identified for high/low fidelity simulation, cultural safety and cultural sensitivity with people in vulnerable situations or Indigenous Peoples. Conclusion This review of systematic reviews identified patient, provider and health system indicators sensitive to PHCNP practice. The findings help clarify how PHCNPs contribute to care outcomes. PROSPERO registration number CRD42020198182.